Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Samuel C. Moore, PMHNPFNP-C

Individual provider Family Medicine Physician · NPI 1659048460

Mr. Samuel C. Moore, PMHNPFNP-C is a Nurse Practitioner in Hartsville, Tennessee. Qualified in 2020, 6 years ago. Practices with Fast Pace Medical Clinic PLLC, a 738-clinician group and accepts Medicare assignment. Licensed in Kentucky and Tennessee.

Years since qualifying
6
Licensed in
KY, TN
In the registry since
2021
Specialties on file
4
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Practice location Address checks out

140 Macon Way
Hartsville, TN 37074-2080
Phone: (615) 808-0400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 29580 (TN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 29580 (TN)
Psychiatry Physician Taxonomy 2084P0800X · Licence 29580 (TN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 3016346 (KY)

Record details

NPI number1659048460
Entity typeIndividual (Type 1)
GenderMale
Credentials PMHNPFNP-C
Sole proprietorYes
NPI enumeratedAugust 28, 2021
Last updated in NPPESJune 13, 2025
Certification dateMay 26, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Fast Pace Medical Clinic Pllc — 738 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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